Why do docs have a problem with worker's comp?

[atomi]

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[Dedikated2liftn]

My guess is the legality of the whole issue.

 

[mjl1717]

I was injured recently at work and go to my doc and the first thing they say to me (before I even mention the term) is "we don't do worker's comp" rather vehemently and kept repeating it over and over. I said fine and just paid them out of pocket because I needed treatment immediately. Then my workplace called them after I filled out a report and they called me and told me that they had called my doctor's office and were rudely refused to be spoken with and hung-up on.

I've been to many other doctors with big signs before that say "No worker's comp" on the front door.

I don't know anything about worker's comp. Could someone please explain to me exactly what it is and why most doctors seem to flip out about it?

it may have to do with hypochondrias and malingering that many do.. (Im not saying you are doing that)I think payments also are slow..

 

[lilnoelle]

My guess is the legality of the whole issue.

I suspect this is the case. The large company I used to work for had a specific physician's office they used - an occupational medicine clinic.

 

[Bushido416]

Any time there is anything with a legal dispute involved that means for the physicians that they will not see reimbursement for services rendered until a settlement has been reached. This could be years and by that time the statue of limitations on their ability to collect could be up. That's what my lawyer says anyway and several physicians I've worked for. Legal issues involved = no insurance company will pay until blame is fully established and then you are able to charge the liable party. Law2Doc could probably explain further but that's what I've been told.

 

[Lshapley]

My understanding is that the reimbursements are terrible and there is a lot of red tape. I have been told to never tell a doctor that I was injured on the job, if I can avoid it (i.e., not trying to get unemployment or collect worker's compensation wages.)

 

[Bananas Foster]

So I used to work for a company that did medical and financial review of workers comp claims.

Issues over delay in payment while the claim is being investigated I'm sure are a big headache, but mostly we dealt with reimbursements, which weren't always pretty. Know that workers comp is heavily regulated at the state level and there are fee schedules for covered treatments and oftentimes this drops the bill dramatically. I personally reduced dozens of $2k-4k bills to less than one half of what they originally charged for, and if the doctor is not familiar with workers comp or was unaware this was a workers comp claim, they are not happy. Also workers comp has specific rules on how you can bill certain procedures that I would guess (judging from my experience) other insurance companies don't have since most doctors have difficulty following these rules.

Also sometimes we'd have doctors upset because there was confusion if it was a worker's comp claim or not, bills would go to the wrong insurer, the insurers would be angry at each other and the doctor would be upset at whoever did his billing.

Some medical billers seemed to somewhat intimidated by the whole review process. Sometimes on complicated bills we would just call up the billing department and negotiate huge discounts because they simply didn't want to deal with the billing review.

 

[45408]

It's along the lines with drug-seekers and ER frequent-flyers. A lot of people will make a workman's comp claim in order to get money/vacation, not because they actually got injured. Doctors don't like facilitating someone else's laziness/drug habit/etc., so they refuse to see any of those patients. Obviously a lot of workman's comp is legit, but it attracts the shadier types as well.

 

[Bananas Foster]

It's along the lines with drug-seekers and ER frequent-flyers. A lot of people will make a workman's comp claim in order to get money/vacation, not because they actually got injured. Doctors don't like facilitating someone else's laziness/drug habit/etc., so they refuse to see any of those patients. Obviously a lot of workman's comp is legit, but it attracts the shadier types as well.

Well, also, there's another side as well. Since for smaller worker's comp insurers and companies a single claim, what with wages and disability rehab can DRAMATICALLY affect premiums, some workers comp insurers will grow very suspicious if a claim drags on for longer than they want. Even if, as their doctor, you thought with your whole professional judgment this patient needed continued care and rehab, you might have to deal with lengthy medical review,submitting all the charts you have to the insurance company, cooperating with outside consultations against your choice, just so the insurance company can confirm your judgment that this patient needs more care.

And i don't even know what happens if the insurance company decides after their review that this patient should be fine and no longer will reimburse you for your services.

 

[Bananas Foster]

Any time there is anything with a legal dispute involved that means for the physicians that they will not see reimbursement for services rendered until a settlement has been reached. This could be years and by that time the statue of limitations on their ability to collect could be up. That's what my lawyer says anyway and several physicians I've worked for. Legal issues involved = no insurance company will pay until blame is fully established and then you are able to charge the liable party. Law2Doc could probably explain further but that's what I've been told.

is Law2doc sorta like a fairy or genie, and whenever legal issues are being discussed all you have to do is say his name 3 times to summon him?

 

[Bushido416]

Well Law guy essentially just pops in on anything legal so I kind mention him as an introduction to him coming to this thread. I'm sure he just searches for his name on these threads and heads in to see what's up. But I find it's just quicker to call my best friend who's my attorney and chat with him about this before a quick game of call of duty4.

 

[Faebinder]

Well you dont need Law2Doc to tell you the story. Work Comp means a dispute and I wont get paid. God I hate insurance companies.

 

[8744]

It's along the lines with drug-seekers and ER frequent-flyers. A lot of people will make a workman's comp claim in order to get money/vacation, not because they actually got injured. Doctors don't like facilitating someone else's laziness/drug habit/etc., so they refuse to see any of those patients. Obviously a lot of workman's comp is legit, but it attracts the shadier types as well.

Not to mention that the paperwork is incredibly intricate and time consuming. A patient shoved a sheaf of forms at me the other day when I walked into the room and said, "Can you fill these out?"

Quietly giving thanks that I am in Emergency medicine, I said, "No. You need to get your own doctor to fill them out."

Most of the workers comp claims are shady just like most of the people collecting disability are malingerers. The legitimate disability claims are a minority among the throng of forty-something men who "hurt their back" twenty years ago and have done nothing since.

 

[8744]

...I don't know anything about worker's comp. Could someone please explain to me exactly what it is and why most doctors seem to flip out about it?

Because we don't like doing paperwork for patients we don't know and have no other relationship with, we don't like being asked to lie on legal documents, and most workers comp seems to be for nebulous back pain that you just know is a ruse to scam the system.

It's like doing sports physicals and the accompanying paperwork. Or well child checks. Very low-skilled work, pays poorly, and requires mucho paperwork.

 

[deleted6669]

Because we don't like doing paperwork for patients we don't know and have no other relationship with, we don't like being asked to lie on legal documents, and most workers comp seems to be for nebulous back pain that you just know is a ruse to scam the system.

It's like doing sports physicals and the accompanying paperwork. Or well child checks. Very low-skilled work, pays poorly, and requires mucho paperwork.

agree- and pays about 25% of what is billed in my area after writing the chart out 3 times on 3 separate forms....

 

[atomi]

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[docB]

So basically a lot of work for not enough money. Fair enough.

I don't get your comment about lying. I cut off part of my finger last week and my family doctor whom I've seen for 20 years and know extremely well refused to see me unless I paid in cash (no worker's comp). And even then he was ticked off. You seem a bit cynical.

It's not cynicism, it's experience. When you get a doctor involved with the work comp system you've put them into a position where they are acting as your witness in a legal proceeding. The lying that Panda talks about is a big deal. Back pain is the biggie. I don't know how they really got hurt or if they had a pre-existing injury and I really don't know if they are actually having pain now or just malingering. But, I've got to fill out their forms and if there's a problem I have to answer letters and possibly even go to depositions or court for all this.

As for wounds like yours it's a little more straight forward. I would guess that your doctor's annoyance was based on a combination of factors.

First it was a work comp case which is a problems for private doc offices that are not used to dealing with it.

Second most private docs know that there are specialized worker's comp clinics that deal with occ med. Your doc probably wishes you'd gone there instead but he didn't want to refuse to see an established patient. On that note he may have been busy and didn't care about the work comp thing and the cash pay policy is probably an office policy that was being enforced by the clerical staff and didn't even involve the doc in your particular instance.

Third many primary care docs aren't that comfortable with wounds, particularly finger wounds and especially partial amputations like you describe. They frequently refuse to see these outright and refer them to the ED.

 

[Faebinder]

I am not even sure if we are able to charge an extra fee straight to the patient to fill that paperwork if the insurance was medicare. Medicare is evil that way, which means physicians will refuse to fill the paperwork.

Just pay the physician and be upfront about it.